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[KiloKAHN]

Update: 9/26/2014
Got my x-rays again on Thursday and afterwards had to wait for two hours to see Dr Parihar and Dr Divya because they were still in the OT and then had to see patients who arrived before me. They spent quite a while looking at my x-rays before calling me in and Dr Parihar told me that depending on the angle of the x-ray and factoring in magnification, I have lengthened somewhere between 5.4 and 5.6 cm. However, to get to my goal of 6 cm it's not going to be a matter of just lengthening for a few more days. The x-rays show that I have some bending in the bones and the right one has more bending than the left, which is why the equinus is not as bad in that one because the bones don't stretch the tissues as much. This means that my bones are not aligned properly and I'll need to correct them. But in order to correct them he may have to compress the legs a little. Because of this, in order to reach my 6 cm goal he wants me to distract another centimeter to around 6.5 cm. After the distraction is done I will need to be admitted to the hospital once again for two days so he can add two pins to the middle of each leg for added stability and then change my frames to a hexapod.

Originally I was supposed to leave for home in the first or second week of October but now he wants me to stay until October 23, just 5 days before my visa expires. I'm continuing my physio and am supposed to practice standing barefoot against the wall as long as possible every day so I can prepare for my full length standing x-ray for the final measurement before I get the pins added. My legs are feeling sore each day and the pin sites and wires are getting more uncomfortable. I still wake up with ankle stiffness in the mornings that I have to alleviate each day with ankle movement exercises, too. Around this amount of distraction is where many patients end up having these sorts of complications which is why Dr Parihar has his 6 cm limit, but he says these can all be corrected and is just one of the things you have to expect to come across in cosmetic lengthening.

Latest X-Rays
 

[GeTs]

Do u know ho much he will charge you for that?

[KiloKAHN]

No charge.

[alps]

Isn't this still his fault?
I think one can control alignment in LON.

[KiloKAHN]

He made it aware before my surgery that with exfix this could happen because of the motion that takes place in the middle and said that if it does he would add the pins and correct with the hexapod. LON should prevent this sort of thing but you're taking the knee pain risk and have to get your bone canals reamed, which I didn't want to deal with.

[ShortyMcShort]

Do you know how long it will take to correct? A week?

Also what do you do these days to keep active and ease boredom? The usual laptop movies, shows, games, etc? Outside those things what else is there to do everyday by yourself?

[KiloKAHN]

Correction with the hexapod won't take long. Divya said it should only take a few days because I don't have to distract and just need to correct the angle.

Yea just the usual. Outside of physiotherapy I've just been using the laptop and occasionally pull out a PS3 game. The days are monotonous and just seem to blend into each other. The most human interaction I get is during my hospital checkups talking to various staff members and sometimes others in the lobby who are there for deformity correction. I had planned to come with a friend but he couldn't get time off work, and because there are no other international cosmetic patients currently I don't really talk to anyone outside of FB messenger.

I think if people came for lengthening with Dr Parihar or Dr Shah it would be cool if they all booked rooms in the same hotel because the doctors are close enough together by taxi and you'd have better social interaction which would help prevent you from feeling down. I've been watching a lot of comedies to keep my mood up.

[KiloKAHN]

Update: 9/30/2014
These last couple days of physiotherapy have been hell. I found out that my equinus was actually worse than I thought it was. My physiotherapist Dr Chaudhary pointed out that when I stand using the walker I end up putting my hips back, which I didn't realize I was doing, and standing with your hips back makes it easier to touch the floor. It's probably why I ended up getting the equinus in the first place because I wasn't standing completely straight. When I have my back and legs touching the wall behind me while standing I get more of a stretch and I can't readily touch the floor with my right foot like a could before. I managed to get my right foot completely touching the floor three days ago and almost did so with my left one, but the last two days my calves have been really sore and the equinus is a little worse, despite me standing a lot and having the straps on constantly. I think it's mostly due to the soreness in the calves from the stretching but I'll have to wait a few more days to see if there's any progress.

The worst part is that the wires by my knees have been extremely painful the last few days. Most positions I move my legs will give me sharp pains at the wires and near one of them if I even touch the top of the skin lightly it feels like electricity in that area. Totally jacked me up during leg extension exercises today. I'm going to ask Dr Parihar if he can cut some skin surrounding the wires by the knees again during the surgery for the extra pins so I can at least extend my legs without wincing.

[Polycrates.]

Kahnny,

The electric jolts should subside immediately after distraction as I said before. I also do the same with my hips and it does really fk up your whole gait, so you're lucky they pointed that out to you so you can't cheat. Bette to hear the truth than be told it's okay and think it's fine when it's not. Hang in there.

[ShortyMcShort]

Hey Kilo I'd like to ask about humerus lengthening, which method did Dr Parihar say he'd use?

[Chocolaty]

Hi Kilo, I am impressd by ur diary bro. How u chose ur doctor by actually visiting them and measuring the pros n cons n providing all this imp information abt all the doctors. I m also planning my visit to India to meet various Indian doctors n do this surgery by this month end. Could u plz have a look at my thread n suggest me accordingly. I would really appreciate that.

[highabovethesky]

i am newbie here...i have a question...may b its stupid....what u people think its better to have slim leg(tibia bone with least muscles) or its better to have big(tibia bone+lot of muscles) for external fixture??

[KiloKAHN]

Kahnny,

The electric jolts should subside immediately after distraction as I said before. I also do the same with my hips and it does really f**k up your whole gait, so you're lucky they pointed that out to you so you can't cheat. Bette to hear the truth than be told it's okay and think it's fine when it's not. Hang in there.

Yea I'm glad it was pointed out to me. Just disappointed that I was spending a lot of time doing that without realizing it. Seems like a whole lot of time standing was wasted because of it.

Hey Kilo I'd like to ask about humerus lengthening, which method did Dr Parihar say he'd use?

I didn't get into real specifics with him but I know from talking to Dr Divya that you can use externals with the unilateral frame and even use LON on humerus. For cosmetic cases I think he'd do both arms at once, as Divya said you can do so and that you don't really lose much function while lengthening the humerus.

Dr Parihar has done humerus lengthening many times before and said it's the easiest segment to lengthen. He showed me some x-rays of non-cosmetic humerus lengthening cases as well.

i am newbie here...i have a question...may b its stupid....what u people think its better to have slim leg(tibia bone with least muscles) or its better to have big(tibia bone+lot of muscles) for external fixture??

Your calves are going to atrophy regardless, but I've spoken to some surgeons who seem sure that adding muscle to your calves before lengthening will be beneficial because it will mean increased blood flow to the area. Having more muscular calves sure seems to make the distraction hurt more than someone with thinner calves though.

[Taller]

This question is almost exclusively just out of curiosity, but, while we're on the topic of arm lengthening, do you know of your team of doctors does forearm lengthening and if they'd be comfortable/safe doin it for cosmetic purposes? I've heard mixed opinions on forearm lengthening and am just curious. I've read that Dr. Solomon will do it for cosmetic reasons, but was wondering about Dr. Parihar, who is one of the few doctors I think I'd trust with such a risky procedure.

Personally, I don't expect my arms to look short after LL. I only plan on exceeding my wingspan by 2-3CM. However, as a last resort, if I did end up looking disproportionate, I think that humerus lengthening might only worsen proportions for me, because my humerus bones are already slightly longer than my forearms.


I was wondering if you could get Dr. Parihar's opinion on this if it isn't too much trouble. Thank you, by the way, and hang in there with the final stretch (pun intended) of your lengthening journey.

[KiloKAHN]

This question is almost exclusively just out of curiosity, but, while we're on the topic of arm lengthening, do you know of your team of doctors does forearm lengthening and if they'd be comfortable/safe doin it for cosmetic purposes? I've heard mixed opinions on forearm lengthening and am just curious. I've read that Dr. Solomon will do it for cosmetic reasons, but was wondering about Dr. Parihar, who is one of the few doctors I think I'd trust with such a risky procedure.

Personally, I don't expect my arms to look short after LL. I only plan on exceeding my wingspan by 2-3CM. However, as a last resort, if I did end up looking disproportionate, I think that humerus lengthening might only worsen proportions for me, because my humerus bones are already slightly longer than my forearms.


I was wondering if you could get Dr. Parihar's opinion on this if it isn't too much trouble. Thank you, by the way, and hang in there with the final stretch (pun intended) of your lengthening journey.

I asked Dr Parihar about forearm lengthening a while ago and he told me that he does do it (though I forgot to ask him if he would specifically do it for a cosmetic case). He showed me a case where he had to do lengthening and deformity correction along with pictures showing the patient's retention of pronation and supination movements. He runs a blog for his site and the most recent blog posts are about forearm cases. The second one in particular is the case he showed me where lengthening was involved. It might be of interest to you.

http://ilizarov-india.blogspot.in/

I'll ask him next time I see him if he'd do forearm lengthening for cosmetic reasons.

[Taller]

Thanks for the information Kilokhan. Dr. Parihar's blog sure serves as a nice reminder that, compared to so many other people out there, we do have it very nice and are fortunate that we are getting put in frames voluntarily instead of out of necessity. Dr. Parihar's work is incredible in trauma cases, though, and it's uplifting to see him making such a positive difference in the lives of many injured and disabled people through his trauma repair procedures.


If you do ask him about cosmetic forearm lengthening, ask him if it is realistic to expect/hope for the retention of full pronation and supination capacity and capability after such lengthening.


Thanks!

[Taller]

Really though, going through the stories and treatments of the trauma patients featured on Dr. Parihar's blog really makes cosmetic lengthening seem like a silly and stupid thing and height neurosis like a trivial matter when compared to these often grotesque and tragic injuries and deformities. It's good to see these cases to put things into perspective.

Kilokhan, is it difficult, psychologically, to have to be in the clinic getting a procedure that you physically don't need while trauma patients who physically need Ilizarov look at you and possibly realize what is going on? Just out of curiosity, how do you rationalize cosmetic LL with a doctor who also does trauma cases from a moral or justice standpoint? How does Dr. Parihar rationalize or make sense of CLL? Does he only do it in cases of "debilitating" height neurosis, or also to fix "annoying" height neurosis. Both assuming that the patient is understanding of the procedure and willing to make the commitments required. Why does he preform CLL when the trauma/deformity patients "need" his Ilizarov skills so much for than cosmetic patients? I apologize if this is too personal, but this is something that has been on my mind a lot lately and I thought I'd ask.

[KiloKAHN]

If you do ask him about cosmetic forearm lengthening, ask him if it is realistic to expect/hope for the retention of full pronation and supination capacity and capability after such lengthening.

Will do.

Kilokhan, is it difficult, psychologically, to have to be in the clinic getting a procedure that you physically don't need while trauma patients who physically need Ilizarov look at you and possibly realize what is going on? Just out of curiosity, how do you rationalize cosmetic LL with a doctor who also does trauma cases from a moral or justice standpoint? How does Dr. Parihar rationalize or make sense of CLL? Does he only do it in cases of "debilitating" height neurosis, or also to fix "annoying" height neurosis. Both assuming that the patient is understanding of the procedure and willing to make the commitments required. Why does he preform CLL when the trauma/deformity patients "need" his Ilizarov skills so much for than cosmetic patients? I apologize if this is too personal, but this is something that has been on my mind a lot lately and I thought I'd ask.

Funny you should ask this now, because last Thursday while I was getting my rods changed by Dr Divya I told him that I sometimes feel a little awkward in the waiting room when I see people come in with bad deformities and extremely complicated frames on them. Mostly because they're going through so much time and pain just to get to functioning normally and here I am voluntarily having my legs broken. I've had people at the hospital come up to me more than once asking what happened to me and pointing out that it's strange I'm wearing a frame on both legs. I always just lied and said I was doing a bowleg correction, but it did force me to look at myself and realize that although I'm doing this in large part to escape the discrimination I've gotten throughout life for being shorter, part of it is definitely due to vanity to a degree.

I haven't spoken to Dr Parihar about his opinion on CLL. He did say during my consultation that he could do the surgery technically well and will do so for serious cosmetic patients, but whether or not he should do it for cosmetic cases is a different question entirely. I didn't go deeper than that, but I think I'll ask him about how he rationalizes cosmetic cases.

[ShortyMcShort]

When you see Dr Parihar next, could you also ask him on his thoughts on lengthening both segments(tibia and femur) consecutively in the space of a whole year? For example, doing 5 or 6cms on tibias first using externals only and stay in India for the whole duration until frame removal and then proceed with Precice 2 femurs for 6 or 7 cms? And go home once the femurs are finished lengthening and be wheelchair bound until femurs are ok for weight bearing?

In my country you can get a one year medical visa so im quite curious about this, not sure if advisable but would like to get Dr Parihars input on the matter.

Thanks in advance Kilo

[KiloKAHN]

This question is almost exclusively just out of curiosity, but, while we're on the topic of arm lengthening, do you know of your team of doctors does forearm lengthening and if they'd be comfortable/safe doin it for cosmetic purposes? I've heard mixed opinions on forearm lengthening and am just curious. I've read that Dr. Solomon will do it for cosmetic reasons, but was wondering about Dr. Parihar, who is one of the few doctors I think I'd trust with such a risky procedure.

Personally, I don't expect my arms to look short after LL. I only plan on exceeding my wingspan by 2-3CM. However, as a last resort, if I did end up looking disproportionate, I think that humerus lengthening might only worsen proportions for me, because my humerus bones are already slightly longer than my forearms.

I was wondering if you could get Dr. Parihar's opinion on this if it isn't too much trouble. Thank you, by the way, and hang in there with the final stretch (pun intended) of your lengthening journey.

Just got out of Dr Parihar's office not long ago and he would not be comfortable doing forearm lengthening for cosmetic purposes. He said there are too many things happening in the forearm and that it's very delicate in that there's a fine balance in the muscles of the forearm. So for him forearm lengthening for cosmetic purposes is as out there to him as clavicle lengthening and hip narrowing.

Humerus lengthening has none of those issues and he'd be okay with doing it. Might not be your ideal but it might look better with the humerus lengthening than with the shorter wingspan. Then again you may even look better with the shorter wingspan and it won't be noticeable.

How does Dr. Parihar rationalize or make sense of CLL? Does he only do it in cases of "debilitating" height neurosis, or also to fix "annoying" height neurosis. Both assuming that the patient is understanding of the procedure and willing to make the commitments required. Why does he preform CLL when the trauma/deformity patients "need" his Ilizarov skills so much for than cosmetic patients? I apologize if this is too personal, but this is something that has been on my mind a lot lately and I thought I'd ask.

He told me that he doesn't have a black and white about it, and that he's not in the head of someone who thinks CLL is something they absolutely need in life so he can't say whether or not CLL is useless to that person. He then said that if there was a state sponsored thing where they provided medical treatment to people, then one has to think as to what patients have the priority and where should the money go, so in that sense treating deformities would take priority over CLL, but in a private setting it doesn't matter. He also said the reason I probably feel a little guilty about getting CLL is that I'm getting it done at his clinic where it's primarily deformities being treated, whereas if I went to one of the flashier settings with a doctor primarily doing CLL, I wouldn't see that side of things. It's also down to individual perception. Someone who isn't sympathetic to others in that situation would not feel guilty if 300 patients were paraded in front of them.

In the end I think he cares more about the prospective patient being absolutely sure that it's the right choice for him.

When you see Dr Parihar next, could you also ask him on his thoughts on lengthening both segments(tibia and femur) consecutively in the space of a whole year? For example, doing 5 or 6cms on tibias first using externals only and stay in India for the whole duration until frame removal and then proceed with Precice 2 femurs for 6 or 7 cms? And go home once the femurs are finished lengthening and be wheelchair bound until femurs are ok for weight bearing?

In my country you can get a one year medical visa so im quite curious about this, not sure if advisable but would like to get Dr Parihars input on the matter.

Thanks in advance Kilo

In regards to lengthening femurs after tibias or vice versa, he said that you should wait until you're back at normal life after the first lengthening before considering a second. Dr Parihar is pretty conservative with how ambitious you should be. He won't even do cross lateral lengthening (even thinks it's crazy for people to do so).

[Wannabegiant]

nice info KiloKahn, hope all is going well for you.

Have to say, Dr Parihar sounds like a very respectable person, seems like a very good choice for anyone who wants to do LL for a good price.

[Polycrates.]

Dr. Parihar is my ideal choice to do femurs with. I just have to see if he is willing to take me on as a patient. From what Kilokahn says, there are many people at his clinic undergoing external procedures on the femur for various deformities, so I am confident he can lengthen me safely with that method. The pain of external should be less than the pain of shelling out 40kUSD for a pair of precice nails.
 

[Taller]

Thanks for asking Dr. Parihar about forearm lengthening. While it's unfortunate that it doesn't seem possible to safely lengthen this particular segment, Dr. Parihar's response demonstrates once again what a responsible and careful surgeon he is. Anyone doing lengthening procedures with him is definitely in very good hands.

[GROWtalORdieTRYING1]

its just a shame that all those people who went to sarin and sringari could have gone to dr parihar instead for the same price.

[ShortyMcShort]

its just a shame that all those people who went to sarin and sringari could have gone to dr parihar instead for the same price.

Agreed, had Sysop/Apo or what ever else he goes by these days(I've lost count) took his time, did his research and not rush into picking the first Indian person with the title Dr. in front of their names, we wouldnt have this forum and previous patients would not have been butchered all in the name of greed. Sigh...

Thanks for the reply Kilo, on a personal note how are things going with you atm? How much have you lengthened and are you having any pain/discomfort atm?

[123]

Dr. Parihar is my ideal choice to do femurs with. I just have to see if he is willing to take me on as a patient. From what Kilokahn says, there are many people at his clinic undergoing external procedures on the femur for various deformities, so I am confident he can lengthen me safely with that method. The pain of external should be less than the pain of shelling out 40kUSD for a pair of precice nails.

Your ideal choice would be to see a psychiatrist...

[GROWtalORdieTRYING1]

I think external femur can be done safely according to clinical studies. but its true we need more diaries to be 100% sure.

I think polycrates is making a logical decision. I think 123 you should rethink why people see psychologists. its not applicable in this case.

I too want to do external femurs. im not going to pay the price of a house for LL when I don't need to.

[123]

I think external femur can be done safely according to clinical studies. but its true we need more diaries to be 100% sure.

I think polycrates is making a logical decision. I think 123 you should rethink why people see psychologists. its not applicable in this case.

I too want to do external femurs. im not going to pay the price of a house for LL when I don't need to.

It's not about external femur, it's that he still isn't satisfied with his height at 184cm + he can't even walk. Sorry, but this is just insane...

I have a lot of friends who are around 185cm and they all consider themselves tall (because they are). So why would you even  think about LL at 184cm? Sorry but I just don't get that...

[Greek-Semidget]

It's not about external femur, it's that he still isn't satisfied with his height at 184cm + he can't even walk. Sorry, but this is just insane...

I have a lot of friends who are around 185cm and they all consider themselves tall (because they are). So why would you even  think about LL at 184cm? Sorry but I just don't get that...

he just hate his femur to tibia ratio, he say it looks really bad

[Taller]

123, it's not as simple or trivial as his tibiae to femur ratio looking bad. It's a matter of it being bad, biomechanically, for running, jumping, balance, and even walking. That is no way to live life.

Femur lengthening would restore an anatomically normal ratio and prevent potential knee and back issues from altered biomechanics down the road, plus allow running and jumping once muscle and nerves have recovered.


Sorry if I'm missing something, but can a psychiatrist do that?

[GROWtalORdieTRYING1]

hmm. well I agree with 123, it is already a tall height and no one should have any height issues at this height.

but I also agree with taller and the biomechanical aspects need to be fixed.

I guess he has no choice but to fix the biomechanical issues (femur to tibia ratio)

in hindsight polycrates should have got less lengthening on tibia, and spread it over both tibia and femur.

4.5cm on each would have been much safer, especially considering external femur.

I personally think that no LL patient should only get 1 segment done. but if people are getting 2 segments done they should not max out each of the segments.